Healthcare Provider Details

I. General information

NPI: 1457888141
Provider Name (Legal Business Name): CYNTHA SUSANNE SEE CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CINDY SEE

II. Dates (important events)

Enumeration Date: 05/12/2017
Last Update Date: 05/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 NORTH MAIN SUITE 2
CENTERVILLE IA
52544
US

IV. Provider business mailing address

PO BOX 658
OTTUMWA IA
52501
US

V. Phone/Fax

Practice location:
  • Phone: 641-856-3112
  • Fax:
Mailing address:
  • Phone: 641-683-6747
  • Fax: 641-683-6317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number06114
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: